Elisabeth M J P Mouws1, Lisette J M E van der Does2, Charles Kik3, Eva A H Lanters2, Christophe P Teuwen2, Paul Knops2, Ad J J C Bogers3, Natasja M S de Groot4. 1. Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. 2. Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. 3. Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. 4. Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: nmsdegroot@yahoo.com.
Abstract
BACKGROUND: Areas of conduction delay (CD) or conduction block (CB) are associated with higher recurrence rates after ablation therapy for atrial fibrillation (AF). OBJECTIVE: Thus far, there are no reports on the quantification of the extensiveness of CD and CB at the pulmonary vein area (PVA) and their clinical relevance. METHODS: Intraoperative high-density epicardial mapping of the PVA (interelectrode distance 2 mm) was performed during sinus rhythm in 268 patients (mean ± SD [minimum-maximum] 67 ± 11 [21-84] years) with and without preoperative AF. For each patient, extensiveness of CD (conduction velocity 17-29 cm/s) and CB (conduction velocity <17 cm/s) was assessed and related to the presence and type of AF. RESULTS: CD and CB occurred in, respectively, 242 (90%) and 183 (68%) patients. Patients with AF showed a higher incidence of continuous conduction delay and block (CDCB) lines (AF: n = 37 [76%]; no AF: n = 132 [60%]; P = .046), a 2-fold number of lines per patient (CD: 7 [0-30] vs 4 [0-22], P < .001; CB: 3 [0-11] vs 1 [0-12], P = .003; CDCB: 2 [0-6] vs 1 [0-8], P = .004), and a higher incidence of CD or CB lines ≥6 mm and CDCB lines ≥16 mm (P = .011, P = .025, and P = .027). The extensiveness of CD, CB, and CDCB could not distinguish between the different AF types. CONCLUSION: Patients with AF more often present with continuous lines of adjacent areas of CD and CB, whereas in patients without AF, lines of CD and CB are shorter and more often separated by areas with normal intra-atrial conduction. However, a considerable overlap in the amount of conduction abnormalities at the PVA was observed between patients with a history of paroxysmal and persistent AF.
BACKGROUND: Areas of conduction delay (CD) or conduction block (CB) are associated with higher recurrence rates after ablation therapy for atrial fibrillation (AF). OBJECTIVE: Thus far, there are no reports on the quantification of the extensiveness of CD and CB at the pulmonary vein area (PVA) and their clinical relevance. METHODS: Intraoperative high-density epicardial mapping of the PVA (interelectrode distance 2 mm) was performed during sinus rhythm in 268 patients (mean ± SD [minimum-maximum] 67 ± 11 [21-84] years) with and without preoperative AF. For each patient, extensiveness of CD (conduction velocity 17-29 cm/s) and CB (conduction velocity <17 cm/s) was assessed and related to the presence and type of AF. RESULTS:CD and CB occurred in, respectively, 242 (90%) and 183 (68%) patients. Patients with AF showed a higher incidence of continuous conduction delay and block (CDCB) lines (AF: n = 37 [76%]; no AF: n = 132 [60%]; P = .046), a 2-fold number of lines per patient (CD: 7 [0-30] vs 4 [0-22], P < .001; CB: 3 [0-11] vs 1 [0-12], P = .003; CDCB: 2 [0-6] vs 1 [0-8], P = .004), and a higher incidence of CD or CB lines ≥6 mm and CDCB lines ≥16 mm (P = .011, P = .025, and P = .027). The extensiveness of CD, CB, and CDCB could not distinguish between the different AF types. CONCLUSION:Patients with AF more often present with continuous lines of adjacent areas of CD and CB, whereas in patients without AF, lines of CD and CB are shorter and more often separated by areas with normal intra-atrial conduction. However, a considerable overlap in the amount of conduction abnormalities at the PVA was observed between patients with a history of paroxysmal and persistent AF.
Authors: Annejet Heida; Willemijn F B van der Does; Mathijs S van Schie; Lianne N van Staveren; Yannick J H J Taverne; Ad J J C Bogers; Natasja M S de Groot Journal: Med Biol Eng Comput Date: 2022-10-12 Impact factor: 3.079
Authors: Denise M S van Marion; Eva A H Lanters; Kennedy S Ramos; Jin Li; Marit Wiersma; Luciënne Baks-Te Bulte; Agnes J Q M Muskens; Eric Boersma; Natasja M S de Groot; Bianca J J M Brundel Journal: Cells Date: 2020-09-16 Impact factor: 6.600
Authors: Willemijn F B van der Does; Annejet Heida; Lisette J M E van der Does; Ad J J C Bogers; Natasja M S de Groot Journal: J Clin Med Date: 2021-06-27 Impact factor: 4.241